Mary Gina Connor, MSW, LCSW

Individual provider Active NPI Clinical Social Worker · Erlanger, KY

NPI 1992729610 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1992729610
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
1557 (KY)
Practice address
495 Erlanger Rd
Suite 204
Erlanger, KY 41018-1468
Phone
(859) 342-6444
Fax
(859) 342-0999
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1557KYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Pathways PLLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1557 KY Yes

Addresses

Primary practice location

495 Erlanger Rd
Suite 204
Erlanger, KY 41018-1468

Mailing address

495 Erlanger Rd
Suite 204
Erlanger, KY 41018-1468
Phone (859) 342-6444

Other providers in Erlanger, KY

All providers in Erlanger, KY · Clinical Social Worker in Kentucky

Sources for this page

Verify at the official NPI Registry.